Tibial Fixation in Anterior Cruciate Ligament Reconstruction With Bone-Patellar Tendon-Bone and Semitendinosus-Gracilis Autografts: A Comparison Between Bioabsorbable Screws and Bioabsorbable Cross-Pin Fixation

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Abstract

Background:

Knee instability after anterior cruciate ligament reconstruction rarely manifests with activities of daily living, but it may occur in high-level sports performance, resulting in secondary injuries. Faced with these circumstances, sports orthopaedists have continued to improve on the results obtained with surgical techniques for treating knee joint injuries.

Hypothesis:

Transverse tibial fixation with bioabsorbable cross pins is a valid technique for anterior cruciate ligament reconstruction with both the patellar tendon (bone-patellar tendon-bone) and semitendinosus and gracilis tendon.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The study population was 120 patients operated on by the same surgeon and subdivided into 4 subgroups of 30 subjects each. Patients were chosen and assigned to each group consecutively. Patients in group 1 (bone-patellar tendon-bone) were implanted with bioabsorbable interference screws, group 2 (bone-patellar tendon-bone) received 2 bioabsorbable cross pins, group 3 (semitendinosus and gracilis tendon) received a bioabsorbable interference screw, and group 4 (semitendinosus and gracilis tendon) received 2 bioabsorbable cross pins. Patients were assessed at 5-year follow-up for International Knee Documentation Committee Knee Ligament Standard Evaluation Form, Lysholm Knee Scoring Scale, Lysholm-Tegner Activity Scale, and KT-1000 arthrometer testing.

Results:

The results at 5 years after anterior cruciate ligament reconstruction were similar across all 4 groups. No significant differences have been observed between groups.

Conclusion:

The results suggest that transverse tibial fixation with bioabsorbable cross pins is a safe and reliable procedure, yielding clinical results that are comparable with those of the more widely used bioabsorbable interference screws.

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